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EMT > 99 Medical Cardiac Arrest > Flashcards

99 Medical Cardiac Arrest Flashcards

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1
Q

What are the INDICATIONS for the MEDICAL CARDIAC ARREST medical directive

A
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2
Q

Which cardiac arrests are 1 analyse and go

A

Trauma
Pregnant over 20 weeks
Hypothermia
Airway Obstruction
Non-opioid OD
Reversible causes

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3
Q

With repeated pulseless VT/VF when do we leave scene?

A

Following 3 rounds of EPI (or 3 shocks, no access)

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4
Q

What is refractory VF/VT

A

VF/VT after 3 consecutive shocks

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5
Q

What are the Hs in Hs/Ts

A

Hypoxia
Hypovolemia
Hypoglycemia
Hydrogen
Hyper/Hypokalemia
Hypo/Hyperthermia

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6
Q

What are the Ts in Hs/ Ts

A

Thrombosis (cardiac and pulmonary)
Tamponade
Tn Pneumo
Trauma
Toxins

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7
Q

What are the CONDITIONS for EPI in CARDIAC ARREST?

A

24 hours
altered
IM: anaphylaxis

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8
Q

What are the CONTRAINDICATIONS for EPI in CARDIAC ARREST?

A

allergy

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9
Q

What is the dose of EPI in CARDIAC ARREST for ANAPHYLAXIS

A

0.01mg/kg (MAX 0.5mg)

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10
Q

What is the dose of EPI in CARDIAC ARREST for 24 hours to 12 years IV/IO/CVAD?

A

0.01mg/kg (MIN 0.05 mg)

0.1ml/kg (MIN 0.5 ml)

1:10,000 epi

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11
Q

What is the dose of EPI in CARDIAC ARREST for 24 hours to 12 years ETT?

A

0.1mg,ml/kg (MAX 2mg ) (MIN 0.5mg)

1:1000 epi

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12
Q

What is the dose of EPI in CARDIAC ARREST for ADULT IV/IO/CVAD?

A

1mg

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13
Q

What is the dose of EPI in CARDIAC ARREST for ADULT ETT?

A

2mg

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14
Q

What is the interval between doses for EPI in CARDIAC ARREST?

A

4 minutes

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15
Q

What are the CONDITIONS for AMIO in CARDIAC ARREST?

A

24 hours
altered
VF/VT

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15
Q

How do we round epinephrine for cardiac arrest?

A

Nearest 0.05mg

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16
Q

What are the CONDITIONS for LIDO in CARDIAC ARREST?

A

24 hours
altered
VF/VT

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17
Q

What is the max initial dose of AMIO in CARDIAC ARREST?

A

300mg

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18
Q

What is the max second dose of AMIO in CARDIAC ARREST?

A

150mg

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19
Q

What are the routes for amiodarone?

A

IV/IO/CVAD

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20
Q

What is the interval between doses for AMIO in CARDIAC ARREST?

A

4 minutes

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21
Q

What is the pediatric dose (24 hours to 12 years) formula for AMIO in CARDIAC ARREST?

A

5mg/kg

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22
Q

How does amiodarone come?

A

150ml/3ml

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23
Q

How MANY doses are given of AMIO in CARDIAC ARREST?

A

2

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24
Q

What is the dose of LIDO in CARDIAC ARREST for PEDIATRIC IV/IO/CVAD?

A

1mg/kg

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25
Q

What is the dose of LIDO in CARDIAC ARREST for PEDIATRIC ETT?

A

2mg/kg

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26
Q

What is the initial dose of LIDO in CARDIAC ARREST for ADULT (12+) IV/IO/CVAD?

A

1.5mg/kg

27
Q

What is the SECOND dose of LIDO in CARDIAC ARREST for ADULT (12+) IV/IO/CVAD?

A

0.75mg/kg

28
Q

What is the initial dose of LIDO in CARDIAC ARREST for ADULT (12+) ETT?

A

3mg/kg

29
Q

What is the SECOND dose of LIDO in CARDIAC ARREST for ADULT (12+) ETT?

A

1.5mg/kg

30
Q

How MANY doses are given of LIDO in CARDIAC ARREST?

A

2

31
Q

What is the interval between doses for LIDO in CARDIAC ARREST?

A

4 minutes

32
Q

For LIDO, how do we remember the ETT dose?

A

Double to IV/IO/CVAD dose

33
Q

What is the infusionof NaCL given in a Cardiac Arrest?

A

20ml/kg

34
Q

What is the max volume of NaCl given in a Cardiac Arrest?

A

2000ml

35
Q

What are extenuating circumstances to patch early for a TOR?

A

Prolonged Egress
Prolonged Transport
Significant clinical limitations

36
Q

What happens during patch failure?

A

Transport to closest, most appropriate hospital

37
Q

Why should NaCl be considered during PEA

A

NaCl increases preload, which increases force of contraction

38
Q

When is a TOR applicable for Medical Cardiac Arrest?

A

No reversible causes

16 years old
altered
Not witnessed by medics
No ROSC
No Defib

39
Q

How does Lidocaine come?

A

100mg/5ml

40
Q

What route is preferred for EPI in cardiac arrest?

A

IV/IO

ETT if IV/IO is delayed by 5 minutes

41
Q

What is the chemical name for Sodium Bicarb?

A

NaHCO3

42
Q

What class of medication is epinephrine?

A

sympathomimetic

43
Q

What class of medication is Amiodarone

A

Class 3 antiarrhythmic (potassium channel blocker)

44
Q

What class of medication is Lidocaine?

A

Class 1b antiarrhythmic (Sodium channel blocker)

45
Q

What class of medication is Sodium Bicarbonate?

A

Buffer/alkalizer/electrolyte

46
Q

What are the indications of Sodium Bicarbonate

A

severe acidosis, prolongued VSA

47
Q

How does Sodium Bicarbonate work?

A

Increases pH
Decreased Potassium in blood

48
Q

What medication should not be in the same line as Sodium Bicarbonate?

A

Dopamine

49
Q

Why is Sodium Bicarb not used in Hyperkalemia?

A

It works slower and the ion shift is not sustained.

50
Q

How is sodium bicarbonate stored?

A

50mEq/50ml Preload

51
Q

What actions of epinephrine is useful during cardiac arrest?

A

A1 vasocontriction
B2 Positive inotrophy, chronotrophy and dromotrophy

52
Q

How does amiodarone work?

A

1: Blocks sodium channels (SLOW conduction)
2: Beta blocking effects (decrease HR)
3: Blocks Potassium to nodal cells
-PROLONG repolarization
-lengthens action potential
-increases refractory period
4: Blocks calcium

53
Q

How does Lidocaine work in Cardiac Arrest?

A

Increases time for the myocyte to reach threshold potential (slows conduction)
Decreases Ventricular irritability
Terminate re-entry pathways

54
Q

Class 1 antiarrhythmics

A

Sodium Channel Blocker

55
Q

Class 2 antiarrhythmics

A

Beta Blocker

56
Q

Class 3 antiarrhythmics

A

Potassium Channel Blocker

57
Q

Class 4

A

Calcium Channel Blocker

58
Q

What happens in phase 0 of the cardiac action potential?

A

Rapid Sodium in thorugh FAST Sodium channels

59
Q

What happens in phase 1 of the cardiac action potential?

A

Potassium Out
Chloride Out

60
Q

What happens in phase 2 of the cardiac action potential?

A

Slow Calcium in
Potassium Out

61
Q

What happens in phase 3 of the cardiac action potential?

A

Potassium Out

62
Q

What happens in phase 4 of the cardiac action potential?

A

Potassium out @ 90mV
Resting potential

63
Q

What treatments can be given to 24 hours to 8 years old undergoing Cardiac Arrest?

A

Epi IV/IO/CVAD 0.01mg/kg
Epi ETT 0.1mg/kg (MAX 2mg) (MIN 0.5mg)
amio 5mg/kg (MAX 300mg, 150)
lidocaine IV/IO/CVAD 1mg/kg
Lidocaine ETT 2mg
NaCl (20ml/kg, reassess 100ml)
Defib 2J/kg, 4J/kg
Adjusted CPR

64
Q

What treatments can be given to an 8-12 year old undergoing cardiac arrest?

A

Epi IV/IO/CVAD 0.01mg/kg
Epi ETT 0.1mg/kg (MAX 2mg) (MIN 0.5mg)
amio 5mg/kg (MAX 300mg, 150)
lidocaine IV/IO/CVAD 1mg/kg
Lidocaine ETT 2mg
NaCl (20ml/kg, reassess 100ml)
Adult Defib
2 handed CPR

65
Q

What treatments can be given to an ADULT undergoing cardiac arrest?

A

Epinephrine IV/IO/ETT 1mg
Epinephrine ETT 2mg
Amio 300mg, 150)
Lidocaine IV/IO/CVAD 1.5 /kg, 0.75 mg/kg Lidocaine ETT 3mg/kg, 1.5mg/kg
NaCl (20ml/kg, reassess 250ml)
Adult Defib
2 handed CPR

EMT (34 decks)

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